Varicoceles in Children
A varicocele is when veins in the
scrotum have become large and swollen (dilated). The condition is like varicose veins
that occur in the legs.
When veins inside the spermatic
cord aren't working properly, the veins can swell. The spermatic cord joins each
testicle to the body. Veins in the cord normally take blood back to the heart. Tiny
valves inside the veins keep the blood flowing in the right direction. Valves that
fully close let the blood flow slowly or pool inside the veins. This buildup of blood
causes the veins to swell.
A varicocele most often occurs in
the left testicle. This may be because of the angle at which blood from the scrotum
enters the kidney veins. It can cause pressure to build up in the scrotum.
The veins in the scrotum may have
valve problems or missing valves. Teen boys grow so quickly that the testicles need
blood than normal. If the veins have even small problems, they may not be able to
the extra blood quickly enough.
Other problems in groin anatomy may also increase the pressure inside the veins and
cause swelling. In rare cases, swollen lymph nodes can block blood flow in the veins
of the scrotum and cause pain.
Most boys with a varicocele don't have any symptoms. When they do occur, symptoms
- Heavy feeling in the testicles that gets worse during or after exercise
- Ongoing dull ache in the scrotum
- One testicle that is smaller than the other
- Swollen blood vessels that can be felt in the scrotum
The symptoms of a varicocele can seem like other health conditions. Make sure your child
sees his healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and
health history. They will give your child a physical exam. The physical exam will
include checking the scrotum. Your child may also have an ultrasound. This is a painless
imaging test that uses sound waves to make images of tissues in the body.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Treatment may be done to ease discomfort or pain. These include:
Lying flat. Lying down flat on the back helps the blood
flow in the right direction and drain from the scrotum.
Underwear that supports the scrotum. This may be an
athletic supporter or underwear briefs.
Pain medicine. Over-the-counter medicines such as
ibuprofen or acetaminophen can help lessen discomfort.
Varicoceles in teens don't often
need treatment, unless the testicle has become much smaller or your child has a lot
pain. Treatment may include surgery or another method to take out or block the vein
the varicocele. The healthcare provider may suggest surgery if the testicles are very
different in size. Surgery in a teen can restore proper blood flow in the scrotum.
can also help preserve the ability to have children (fertility) later.
Talk with your child’s healthcare providers about the risks, benefits, and possible
side effects of all treatments.
If untreated, a varicocele may affect the ability to have children
(fertility) later. It can affect the ability of sperm to swim to an egg (reduced sperm
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- A varicocele is when veins in the scrotum have become large and swollen (dilated).
- In most cases, there are no symptoms.
When symptoms do occur, they can include a heavy feeling in the testicles, a dull
ache in the scrotum, or one testicle that is smaller than the other.
- Treatment is needed if the testicle has become much smaller or your child has a lot
of pain. Treatment may include surgery or another method to take out or block the
vein with the varicocele.
- Your child can ease pain by lying flat, wearing supportive underwear, and taking pain
- If not treated, it may affect the
ability to have children (fertility) later.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.